Hamakawa Masamitsu, Arita Machiko, Takahashi Hiroshi, Amano Akihiko, Hamao Nobuyoshi, Tanaka Ayaka, Ito Akihiro, Ishida Tadashi
Department of Respiratory Medicine, Kurashiki Central Hospital, Okayama, Japan.
Respir Med Case Rep. 2024 Nov 13;52:102142. doi: 10.1016/j.rmcr.2024.102142. eCollection 2024.
The efficacy of mepolizumab as an alternative to glucocorticoids for treating idiopathic chronic eosinophilic pneumonia (ICEP) has been reported. However, various questions remain unanswered, such as the most appropriate dose and dosage interval of mepolizumab for ICEP, how long efficacy is maintained, how long administration should be continued, and whether and when discontinuation can be considered. We present herein three cases of refractory ICEP treated with mepolizumab at a dose of 100 mg every 4 or 8 weeks. No recurrences were observed after 77 months of treatment in Case 1 and after 45 months in Case 2. Case 3 was treated with mepolizumab for 33 months, but ICEP relapsed 42 months after discontinuation of mepolizumab. In conclusion, mepolizumab for refractory ICEP should be continued for as long as possible, considering disease status, glucocorticoid-related adverse events, and the financial situation of the patient.
已有报道称美泊利单抗可作为糖皮质激素的替代药物用于治疗特发性慢性嗜酸性粒细胞性肺炎（ICEP）。然而，仍有诸多问题尚未得到解答，例如美泊利单抗用于ICEP的最适剂量和给药间隔、疗效能维持多久、应持续给药多长时间，以及是否以及何时可以考虑停药。我们在此报告3例难治性ICEP患者，每4周或8周接受100 mg美泊利单抗治疗。病例1治疗77个月后未观察到复发，病例2治疗45个月后也未复发。病例3接受美泊利单抗治疗33个月，但在美泊利单抗停药42个月后ICEP复发。总之，对于难治性ICEP，应根据疾病状况、糖皮质激素相关不良事件以及患者的经济状况，尽可能长时间地持续使用美泊利单抗。
